While the health sector languishes... 'people are a deadin'

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While the health sector languishes... 'people are a deadin'

Hamlet Nat ion

Sunday, November 24, 2019

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On October 14, 2015 this newspaper published an article I wrote entitled 'More than lip service needed for Ja's health care'. Four years have passed and we are at it again.

Recently we were bombarded with frequent news reports of the horrors Jamaicans are experiencing accessing health care. We get the oh, so familiar and predictable responses from our officials and stakeholders. It is as if the press releases have been pre-written and are in someone's e-mail ready to be sent to the news media.

We are usually promised an investigation — which nobody follows up. Nothing is found to be wrong. No one is held accountable, or recommendations are made which are not implemented. In the end, the usual press conference is held with the biggest of wigs in the health care sector, and it might get even juicier with an announcement of a multimillion-dollar contract signed or one is said to be in the pipeline.

There is the usual banter in traditional media circles, chatter among the usual social commentary voices, and there is outrage on social media. We “buss a belch”, it's all off our chest, and the public is appeased. Then the political die-hards point fingers at each other with the usual green and orange against each other.

This season, however, has seen a special finger pointing with orange against orange. A few more days pass, then same script, different cast; no change.

Sadly, while all this is happening the “people are a deadin” and there is palpable suffering and anguish being experienced by all Jamaicans who must access our health care services.

There is the false comfort by some who believe this problem only affects the poor. But a recent encounter has reminded me that we will all likely end up at a public health care facility, whether we are rich or poor, particularly if you have a major health event such as an accident, a condition requiring intensive care, or a sick child who requires hospitalisation. There are no exceptions, even if you own half of Jamaica.

One would think the past and current reality would motivate us to be the greatest protectors of our own health and to be advocates for serious reform and accountability in the Jamaican health care system. Oh, how we need a health care system which responds to the needs of all the population. However, regrettably, most Jamaicans, including our elected officials, are members of the 'Nine-Day Wonder Club'; we talk up a storm as soon as an issue is brought to national attention, but in nine days our pontification ends until the issues again come around to bite us.

If there is anyone in power willing to listen, here are a few suggestions to help improve the health services in Jamaica:

1. The Ministry of Health and Wellness should independently review how outbreaks are managed both at the national level and health care delivery levels. In all the recent epidemics — chikungunya, Zika virus, dengue — the public has found the health system wanting. Stop making excuses, use the opportunity to improve and better the perceived lacklustre, disjointed and confusing response. It is not beyond us to have the 'Jamaica Moves' in how we manage epidemics.

2. Put in the resources to deal with the increased demand at health care facilities. On one hand we have been asking the public to visit the health care facilities, but on the other hand the facilities do not have the resources to deal with the demands.

In my over 10 years of medical practice I have never seen a patient who cares whether the health care provider thinks his/her problem is an emergency or not. Patients care about getting timely and appropriate care. They don't go to the hospital or clinic to have a picnic. We need to stop pretending the facilities always have the resources in diagnosis, treatment, and care to deal with the cases that are turning up for care.

3. Let us take a “all hands-on deck” approach in providing health care. Develop the protocols which will enable the system to mobilise the private sector in our national response to outbreaks through the network of willing medical practitioners. Empower the regional health authorities and local managers to mobilise the resources required to effectively care for their local populations.

It is not acceptable that in a time of crisis only junior staff members are on the front line, while the senior staff are comfortably at home collecting their on-call allowances. Can you imagine the impact on emergency room waiting times if three to five additional doctors each see an additional five to 10 patients per shift?

4. Address the issue of abuse of health care staff. There is no excuse to be abusive or violent towards health care professionals in the exercise of their duties. Security protocols needs to be revised, legislation with stiff penalties should be enacted, and a public education campaign launched to address this issue.

5. Establish an independent health complaints/regulatory body or commission. This body should be tasked and empowered to carry out reviews and audits of both private and public health care services and respond to the complaints of the general public. This, if implemented correctly, would be a good thing for the system. The average man must feel there is an easily accessible and independent body which will be able to investigate and impose sanctions on health care professionals if they behave outside of acceptable clinical and professional norms. For those who may say, that's the role of the professional councils and the Ministry of Health and Wellness, my simple question would be: How effective have they been? Do you as a non-medical person trust that a group disproportionately compromised and influenced by medical individuals will fairly assess your complaint against another medical professional? The Ministry of Health and Wellness is still involved in the business of health care delivery and, hence, ought not to house such a body.

Hopefully, this time around we will do more than just talk. Hopefully we will examine ourselves critically and make the necessary improvements where we have been found wanting. More importantly, we must take the actions necessary to improve our population's experience and rebuild their confidence in the Jamaican health services.

Dr Hamlet Nation is a public health and management consultant. Send comments to the Observer or drhamletnation@yahoo.com.


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